Caring and Preparing

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The Goal of Good Care

We want to do our best to ensure our elderly parents have the most comfort we can provide as they are approaching the end of their life so that they feel loved, valued and respected.

But what are the right choices? Who has the right to make them? How can we be the most prepared for all that is to come? What are their spiritual beliefs and how will that factor into thinking about preparing for their end-of-life care? Ugh, every time I say that my heart drops, doesn’t yours?

After mom’s open-heart surgery, my brothers and I found ourselves asking each other these very questions and I’m so glad we did. I don’t know what the answers are for you, but I think these questions can help start the conversation with your family in a loving way.

Do it before it’s truly too late. If we want our parents to feel loved and respected in their last days, we need to respect their wishes and terms. We may not agree, but we need to honor them regardless of your own personal beliefs.

Choices to Think About

There’s a lot of confusion when we start looking at end-of-life care. I’m not an expert, but here is a list of terms that most people find confusing. Each are linked to articles that will help you, as it did me become better educated on each topic. I hope this information will help you better navigate the conversation between you and your loved ones.

• Hospice
• Palliative Care
• Food & Hydration
• Withholding and Withdrawing

Advanced Directive Planning

Advance Directives aren’t just for Seniors, it’s for all competent people over the age of 18 who are faced with a serious injury or illness. Did that ever occur to you? Not me. But in search of understanding an Advanced Directive, this really struck me so I thought I’d share it with you too.

There is so much involved in being prepared. The following list will give you a road map to help you process all that needs to be considered when planning an Advance Directive for you or your loved one. In short, and Advance Directive is a legal document that states what kind of medical treatment you wish to have if you’re unable to communicate it yourself in the event that you are:

• In a coma
• Seriously injured
• Terminally ill
• Diagnosed with severe dementia

POLST – Physicians Orders for Life-Sustaining Treatment

• For those diagnosed with serious illness
• Consult your doctor to fill out forms
• Does not replace Advance Directive
• Ensures you get the medical treatment you want

DNR – Do Not Resuscitate

• Can be part of an Advance Directive
• Is a request not to receive CPR when the heart stops or breathing stops
• Your doctor will note it in your medical chart
• DNR is accepted statewide
• Is not required to be part of a Living Will or Advance Directive to fulfill the wishes of the individual

Be devoted to one another in love. Honor one another above yourselves. Romans 12:10

Living Will

A Living Will is a written, legal document that specifies what medical treatments you would and/or would not want to be used in being kept alive. In addition, it states other medical preferences, such as pain management, organ donation, etc. You need to address a number of possible end-of-life care decisions in your living will. I encourage you to talk to a doctor if you have questions about any of the following medical decisions:

• Cardiopulmonary resuscitation (CPR) restarts the heart when it has stopped beating. Determine if and when you would want to be resuscitated by CPR or by a device that delivers an electric shock to stimulate the heart.
• Mechanical ventilation takes over your breathing if you’re unable to breathe on your own. Consider if, when and for how long you would want to be placed on a mechanical ventilator.
• Tube feeding supplies the body with nutrients and fluids intravenously or via a tube in the stomach. Decide if, when and for how long you would want to be fed in this manner.
• Dialysis removes waste from your blood and manages fluid levels if your kidneys no longer function. Determine if, when and for how long you would want to receive this treatment.
• Antibiotics or antiviral medications can be used to treat many infections. If you were near the end of life, would you want infections to be treated aggressively or would you rather let infections run their course?
• Comfort care (palliative care) includes any number of interventions that may be used to keep you comfortable and manage pain while abiding by your other treatment wishes. This may include being allowed to die at home, getting pain medications, being fed ice chips to soothe mouth dryness, and avoiding invasive tests or treatments.
• Organ and tissue donations for transplantation can be specified in your living will. If your organs are removed for donation, you will be kept on life-sustaining treatment temporarily until the procedure is complete. To help your health care agent avoid any confusion, you may want to state in your living will that you understand the need for this temporary intervention.
• Donating your body for the scientific study also can be specified. Contact a local medical school, university or donation program for information on how to register for a planned donation for research.

Protecting Your Loved One

It’s a lot to take in, isn’t it? Know the difference between an Advanced Healthcare Directive and a Living Will by clicking here. You may want to consult with your family attorney for more details. It is essential to educate yourself. Take the time to read up on all the pros and cons of all the different end-of-life care. As a result, you can to help your elderly parents make an educated decision. Give you and your family peace of mind in knowing exactly what their wishes are.

My husband and I included an Advance Directive in our Living Trust. We do not want our children to be burdened with such an emotional decision. These conversations aren’t easy to have, especially when emotions are high. Furthermore, making the decision on the spot is more difficult. Do you really want to give the burden to someone?

Imagine the guilt that a person may have to endure after making such a decision to remove life support. I sure wouldn’t want to be that person. My brothers and I know what mom’s wishes are and that gives us all the peace of mind we need. Don’t you want that same peace of mind? Don’t wait till it’s too late.